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01/16/2017 09:57 am ET | Updated 11 hours ago
Jonathan Cohn
President-elect Donald Trump says he’s putting the finishing touches on his plan to replace Obamacare.
It sounds absolutely terrific, like the best health plan ever!
It also sounds wildly out of step with what Republicans in Congress, or even some of Trump’s own advisers, have said they would like to do.
Trump’s comments, which he made in an interview with The Washington Post that appeared Sunday, could mean he’s gone rogue and decided that, at least on health care policy, he has more in common with Sen. Bernie Sanders (I-Vt.) than House Speaker Paul Ryan (R-Wis.).
Or they could mean that, in reaction to public anxiety and recent protests over the possibility of more than 20 million people losing insurance, Trump is already misleading people about what he and his Republicans are planning to do.
Or Trump’s statements could mean that he has no idea what he’s talking about.
Speaking to the Post’s Robert Costa, Trump said his new health care plan would mean “insurance for everybody” with “much lower deductibles.”
Also, Trump said, he will call for the government to negotiate with pharmaceutical companies directly, forcing them to lower their prices.
“They’re politically protected but not anymore,” Trump said of the drug industry.
Trump didn’t offer more details about what he has in mind, or give a precise date for when his plan would be ready for the public to see. But, he said, “It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon.”
Trump added that he would probably wait until his nominee for secretary of health and human services, Rep. Tom Price (R-Ga.), has gone through the confirmation process and taken office. The Senate Finance Committee, which has jurisdiction over Price’s appointment, has not yet scheduled a hearing.
Making sense of Trump’s comments on policy is never easy, and in this case the comments are more confusing than usual.
Providing everybody with health insurance and protecting them from excessive medical costs has been a longtime goal of the Democratic Party, going back to the 1940s. Those efforts eventually led to the Affordable Care Act, which has brought the number of Americans without coverage to a record low, improving access to health care and reducing financial insecurity.
Obamacare has its trade-offs. The coverage that many consumers have obtained through the program includes high deductibles or other forms of out-of-pocket spending, fueling the political backlash against it. Primarily that’s because the law’s new requirements on insurance, such as guaranteeing coverage of pre-existing conditions, made insurance more expensive ? and the law’s financial assistance phases out with higher incomes.
It’s a problem that even many of the law’s supporters have said they want to fix. Both Obama and 2016 Democratic presidential nominee Hillary Clinton proposed offering consumers more assistance with out-of-pocket costs and using government leverage to bring down drug prices.
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